Incentive-based policies have been shown to be powerful in many areas of behavior, but have rarely been tested in the sexual domain. The Rewarding Sexually Transmitted Infection Prevention and Control in Tanzania (RESPECT) study is a randomized controlled trial testing the hypothesis that a system of rapid feedback and positive reinforcement that uses cash as the primary incentive can be used to reduce risky sexual activity among young people, male and female, who are at high risk of HIV infection.
... See More + The study enrolled 2,399 participants in 10 villages in rural southwest Tanzania. The intervention arm received conditional cash transfers that depended on negative results of periodic screenings for sexually transmitted infections, an objectively measured marker for risky sexual behavior. The intervention arm was further divided into two subgroups, one receiving a high value payment of up to $60 over the course of the study ($20 payments every four months) and the other receiving a lower value payment of up to $30 ($10 payments every four months). At the end of the one year of intervention, the results showed a significant reduction in sexually transmitted infections in the group that was eligible for the $20 payments every four months, but no such reduction was found for the group receiving the $10 payments. The effects were stronger among the lower socioeconomic and higher risks groups. The results of a post-intervention follow-up survey conducted one year after discontinuing the intervention indicate a sustained effect among males, but not among females.
See Less -

This brief summarizes the results of a gender impact evaluation study, entitled Incentivizing safe sex : a randomized trial of conditional cash transfers for human immunodeficiency virus (HIV) and sexually transmitted infection (STI) prevention in rural Tanzania, conducted between 2009 and 2010 in Tanzania.
... See More + The study observed the impact of conditional cash transfers as an HIV and STI prevention strategy to incentivize safe sex on the individual level. The main outcome indicator is relative risk (RR), the prevalence of STIs of the treatment group divided by the prevalence of STIs for the control group. The RR for the high value transfer was 0.8, but this is not statistically different than 0, but the adjusted RR did have a significant impact. While the unadjusted results are not significant for men and women, the results for just men are significant. The high-value treatment had a significantly greater impact than the low-value treatment. Funding for the study derived from the World Bank Research Committee, the Spanish Impact Evaluation Fund, the Knowledge for Change Program, and the William and Flora Hewlett Foundation.
See Less -

Using behavior change to tackle human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS) in the developing world is not easy.
... See More + For years, the global community has zeroed in on behavior change as a key to fighting the global HIV epidemic. But so far, the approach has brought only limited success in reducing HIV infections in developing countries. The frustrations are especially evident in sub-Saharan Africa, which has two-thirds of the worlds HIV infections. Women and girls, in particular, are at greater risk, partly because of the biological, social and economic challenges they face. A large randomized trial involving cash incentives is showing promise in reducing sexually-transmitted infections (STI) in Tanzania. The trial is modeled on conditional cash transfer programs, which use cash payments to encourage good behaviors, such as attending schools or getting basic health care. Conditional cash transfer programs complement current programs on behavior change. These programs can be introduced at a low marginal cost.
See Less -

HIV-prevention strategies have yielded only limited success so far in slowing down the AIDS epidemic. This paper examines novel intervention strategies that use incentives to discourage risky sexual behaviors.
... See More + Widely-adopted conditional cash transfer programs that offer payments conditioning on easily monitored behaviors, such as well-child health care visits, have shown positive impact on health outcomes. Similarly, contingency management approaches have successfully used outcome-based rewards to encourage behaviors that are not easily monitored, such as stopping drug abuse. These strategies have not been used in the sexual domain, so this paper assesses how incentives can be used to reduce risky sexual behavior. After discussing theoretical pathways, it discusses the use of sexual-behavior incentives in the Tanzanian RESPECT trial. There, participants who tested negative for sexually transmitted infections are eligible for outcome-based cash rewards. The trial was well-received in the communities, with high enrollment rates and more than 90 percent of participants viewing the incentives favorably. After one year, 57 percent of enrollees in the "low-value" reward arm stated that the cash rewards "very much" motivated sexual behavioral change, rising to 79 percent in the "high-value" reward arm. Despite its controversial nature, the authors argue for further testing of such incentive-based approaches to encouraging reductions in risky sexual behavior.
See Less -

Malaria is still a devastating disease in sub Saharan Africa where it kills at least one million people every year (United Nations Children's Fund, or UNICEF 2003).
... See More + Children are most vulnerable to malaria attacks, which kill more than 3,000 children every day, largely in Africa. At least 100 Tanzanian children die daily because of the disease. Another high-risk group is pregnant women. However, all other adults are also exposed to substantial risk of malaria. In Tanzania, control and care of malaria puts a huge burden on financial and economic costs both at micro and macro levels, thus translating into enormous poverty implications. As such, malaria has a potential in slowing down the achievement of the millennium development goals (MDGs) in countries where it is endemic as is the case in many parts of Tanzania.
See Less -

Malaria is still a devastating disease in sub Saharan Africa where it kills at least one million people every year (United Nations Children's Fund, or UNICEF 2003).
... See More + Children are most vulnerable to malaria attacks, which kill more than 3,000 children every day, largely in Africa. At least 100 Tanzanian children die daily because of the disease. Another high-risk group is pregnant women. However, all other adults are also exposed to substantial risk of malaria. In Tanzania, control and care of malaria puts a huge burden on financial and economic costs both at micro and macro levels, thus translating into enormous poverty implications. As such, malaria has a potential in slowing down the achievement of the millennium development goals (MDGs) in countries where it is endemic as is the case in many parts of Tanzania.
See Less -